Hi, I’m
Ava Y. Lane
Indiana
Overview
23
years of professional experience
Work History
Northwestern Memorial Hospital
Financial Clearance Specialist (remote)
04.2013 - Current
Job overview
- Secure chemotherapy drugs for the Hematology Oncology Department, as well as High dollar radiology
- FDA, NCCN, NGS guidelines and insurance medical policies
- Reviews and analyzes all required demographic, insurance/financial and clinical data procured by patient intake and registration areas necessary to expedite payment on patient accounts
- Expert experience with denials and appeals
- Maintain patient confidentiality per HIPAA regulations
- Verify eligibility and benefit information using on-line programs
- Frequent consults with MD's, RN's as well as insurance companies to obtain authorization for patient service, credentialing knowledge
- Thorough understanding and working knowledge of CPT and ICD-10 coding for billing purposes
- Extensive knowledge of medical terminology, anatomy & physiology
- Strong understanding of Medicare/Medicaid rules and, as well as Comercial plans regulations, and managed care products
- Knowledgeable of current contracted and non-contracted healthcare insurance plans
- Effective communication, interpersonal and organizational skills
- Demonstrate teamwork by helping co-workers within and across departments.
- Epic Super User.
Near North Health Service
Lead Office
09.2010 - 01.2013
Job overview
- Provided front desk administrative support in Primary Care Clinic
- Registers and assesses participants for program eligibility and screens participants for other social service needs or benefits and entitlements services
- Inform patients of any issues with securing the financial account for their encounter and completes out-of-pocket estimations as requested by patients
- Performs operator functions, answers and accurately directs incoming calls from patients, data entry, community organizations, medical organizations, and other external parties
- Educates participants regarding patient responsibilities, services, sliding fee scale, patient rights, grievance policy, and confidentiality
- Collected participant financial assessment documentation prior to assigning sliding fee scale discount
- Screens participants for other social service needs or benefits and entitlements services
- Maintained thorough understanding of medical coverage and third-party liabilities, inclusive of Medicaid IDPA and Medicare
- Verifies and updates third party insurance.
Rehabilitation Institute of Chicago
Human Resource Coordinator (Contract)
02.2009 - 01.2010
Job overview
- Performed complex record keeping and data file maintenance tasks such as gathering, sorting, and filing materials
- Prepared new hire benefit packets, schedule new hires for orientation, schedule new hire physicals
- Physician credentialing organizing and verifying the professional records that qualify a doctor to practice medicine
- Monitor upcoming renewal dates and work with medical staff to advise them of the required steps to maintain their credentials
- Verification of I-9 and Employment eligibility
- Processes nonreimbursable/reimbursable license requests, ensures current professional licenses are on file, and follows up on missing information
- Assist health plan providers and customers with phone inquiries
- Reception duties, prepares and distributes materials as needed and coordinates meeting logistics such as catering, AV equipment, etc
- Attends meetings and composes minutes
- Follows up with receipts and cost center resource
- Performed background screening as well as IDPH fingerprinting.
Robert Half International
Administrative Office Assistant
06.2001 - 01.2009
Job overview
- Provided sales support for 12 Recruiting Managers within three different divisions of Accountemps
- Managed as well as administered weekly payroll for 50 full-time employees in the Salaried Professional Program
- Maintain accurate and well-ordered documentation on all candidates
- Performed background checks, reference checks and education verifications on potential candidates
- Exercise independent judgment, decision-making abilities and high level of confidentiality
- Coordinated and perform a range of staff as well as operational support activities for the unit; serve as a liaison with other departments and operating units in the resolution of day-to-day administrative and operational problems
- Maintained weekly client visit schedule for 12 recruiting managers
- Compiled and upload sales and purchase orders into system on schedule
- HR responsibilities including verifying I-9, W-4 forms and Employment eligibility, vacation/sick time prior to approval, answering benefit questions as they relate to employees medical insurance, dental insurance, tuition reimbursement, bonus eligibility, extended offers of employment to selected candidates under the direction of the staffing managers, closing out terminated employees with proper documents
- Assisted recruiting efforts with internet marketing and pre-screening of candidates for open positions
- Performed a weekly audit on personnel files and information to ensure candidate compliance with RHI policies
- Created excel spreadsheets to track leads, candidates, sales targets and goals and overall performance of the sales team
- Delivered world class customer service.
Education
Harold Washington CollegeChicago, IL
Business Administration
Skills
- Securing Authorization (High Dollar Radiology, Oncology Chemotherapy)
- Document Verification
- Knowledge of all Comercial insurance plans, Medicare/Medicaid
- Ms Word
- Teamwork and Collaboration
- Time Management
- Reliability
- Bill Payment and Recordkeeping
- Customer service
- Microsoft Office
- Financial records and reporting
- Data Entry
- Interpersonal Skills
- Data Entry and 10-Key
- Audit reporting
- State Regulation Compliance
- Credentialing
- Human Resources Skills
- Medical Terminology
Timeline
Financial Clearance Specialist (remote)
Northwestern Memorial Hospital
04.2013 - Current
Lead Office
Near North Health Service
09.2010 - 01.2013
Human Resource Coordinator (Contract)
Rehabilitation Institute of Chicago
02.2009 - 01.2010
Administrative Office Assistant
Robert Half International
06.2001 - 01.2009
Harold Washington College
Business Administration